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The San Diego County medical Society foundation stages the Saturday surgery days about four times a year. It's a part of their efforts to help poor San Diego with unmet medical needs. Barbara, what are these Saturday surgeries about? It is part of what we do through project acts of San Diego. Of approximately 850 patients that we take care of every year about 30% of them require surgery and we do about half of those surgeries on any given Saturday working with a surgery center or hospital that is designating that time as their charity care day. We are working to set a date with surgery one which owns four different surgery centers in San Diego. Where working with Carlsbad surgery center. Kind of surgeries will people be getting this Saturday? This Saturday will be doing eight hernia surgeries where patients have had hernias siding -- some of them as long as seven years ago and have been working to support their families in great pain. Most people if they have a hernia that is extended that long is often disabled and not able to work. We have to patients that have been unable to work because of the pain. Most of the patients that need hernia surgery needed because they work with their bodies. They are gardeners, housekeepers and work in restaurants. They are often time lifting heavy things and become injured through that process. Had you identify patients with a free surgeries? Patients are referred to as from their primary care providers. The network of community clinics that can provide primary care for their patients and uninsured patients that are not able to provide specialty care so they refer them to us and we link them with a physician who volunteers with us to provide pro bono care and then the physician when necessary order for a surgery. We spoke to one woman Patricia Coleman from San Diego that thinks for project access had a kidney store dissolved back in 2014. She said she was in terrible shape before she had the procedure. I've been suffering like you can't imagine. The pain and continues infection. I was throwing up because it was so bad. It was horrible. They changed my life. I'm telling you project access is a God sent. How unique is Patricia's reaction after these kinds of surgeries? Our patients are amazingly grateful for the care that they are given by so many of the community physicians who give up their time and see their patients in their offices and when necessary provide surgeries pro bono. Barbara, in this day and age of Obama care when everyone is supposed to have health insurance why do we still need to provide free surgeries for people? There is approximately 200,000 people adult in San Diego County that remain uninsured. Of those about 50% of them are uninsured because they have switched jobs and health insurance is not available to them or one person in the family is covered by health insurance of their employer but the cost of dependent coverage is so high that it might cause them 40 or 50% of their monthly salary so they can't afford it and they are not eligible for any of that subsidies through colored California plans or they recently been divorced or there's other life issues that have created a void for them for health insurance. About 50% of them are hard-working adults in our community who don't have the legal documentation required for them to qualified for Medi-Cal or the ability to buy a California plant. How large is the unmet surgical meet in San Diego County? If we think there's approximately 30% of the patients that come to us that need surgery -- not everyone who is uninsured is unhealthy. Most people insured or uninsured don't go to the doctor unless they have a health issue. It's hard to project exactly how many people -- hemi-searchers are required but I would say for the most part our patients have been to the emergency room time and time again for they are even refer to us for care so what we have been able to prove is for the patients we serve we have been able to reduce the return emergency department visits by over 85%. We are working to save funds and healthcare dollars throughout our community as well as taking care of our patients. What happens when someone that does not have insurance who needs surgery goes to a community clinic? What can they do for this person? The community clinic is chartered to provide primary care so through their funding from the federal government as a federally funded health Center they are not allowed to provide specialty care unless they have a particular expanded scope of service. We provide that safety net for the safety net. Let's talk about the safety net. Considering that you guys are providing free surgeries year round and periodic events how robust is that medical safety net in San Diego? We have a very robust community center. We also have free clinics and a number of others in town. Access to primary care is a little tighter just because so many more people are accessing primary care as so many people are insured out through the expanded Medi-Cal so getting an appointment sometimes can take a little bit of time. What are the logistics involved in getting all the medical personnel together in the surgery center ready for these free surgery events? For instance, this Saturday at the Carlsbad surgery center will have two surgeons and to anesthesiologist. They will be assisted by a few medical text and a nurse and someone who is cleaning up the ORs between surgeries. We will have the front office staff there to check people in as well as our staff pack. In addition to the four positions we will have 25 other volunteers who medical personnel and are giving up their Saturday as well as the physicians to provide care for these uninsured patients and they love it. We often have someone who comes in with a guitar and played guitar for the staff in the patients in the recovery room and of course we have our staff and we use volunteer medical interpreters to make sure that the expense for the patient is excellent. Thank you very much. I've been speaking with Barbara Mandel executive director of the San Diego County medical Society foundation. I'm Kenny Goldberg and this is midday edition on KPBS.